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越南孕妇的阴道定植菌及产超广谱β-内酰胺酶细菌

Maternal Vaginal Colonization and Extended-Spectrum Beta-Lactamase-Producing Bacteria in Vietnamese Pregnant Women.

作者信息

Viet Nguyen Thanh, Van Du Vu, Thuan Nghiem Duc, Van Tong Hoang, Toan Nguyen Linh, Van Mao Can, Van Tuan Nguyen, Pallerla Srinivas Reddy, Nurjadi Dennis, Velavan Thirumalaisamy P, Son Ho Anh

机构信息

Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi 121-08, Vietnam.

National Hospital of Obstetrics and Gynecology, Hanoi 110-02, Vietnam.

出版信息

Antibiotics (Basel). 2021 May 13;10(5):572. doi: 10.3390/antibiotics10050572.

Abstract

Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) resistance to commonly prescribed drugs is increasing in Vietnam. During pregnancy, ESBL-E may predispose women to reproductive tract infections and increases the risk for neonatal morbidity. Vaginal colonization and infections by and are seldom studied in Vietnam. In this study, we investigated ESBL-producing Enterobacterales in the birth canal of pregnant women. Between 2016 and 2020, vaginal swabs were collected from 3104 pregnant women (mean gestational age of 31 weeks) and inoculated onto MacConkey agar plates. Colonies were subjected to direct identification and antimicrobial susceptibility testing using the VITEK-2 automated compact system and disk diffusion. ESBL production was determined phenotypically. , were identified in 30% (918/3104) of the vaginal swabs, with being the most common (73%; 667/918). ESBL-production was detected in 47% (432/918) of Enterobacterales, with frequent multidrug-resistant phenotype. The overall prevalence of carbapenem resistance was low (8%). Over 20% of spp. were carbapenem-resistant. Pregnant women had a high prevalence of colonization and may transmit ESBL-E to neonates at birth, an important risk factor to be considered. The high rate of ESBL-producers and carbapenem resistance in Enterobacterales in Vietnam emphasizes the need for consequent surveillance and access to molecular typing.

摘要

在越南,产超广谱β-内酰胺酶肠杆菌科细菌(ESBL-E)对常用处方药的耐药性正在增加。在孕期,ESBL-E可能使女性易患生殖道感染,并增加新生儿发病风险。在越南,很少有人研究 和 在阴道的定植及感染情况。在本研究中,我们调查了孕妇产道中产ESBL的肠杆菌科细菌。2016年至2020年期间,从3104名孕妇(平均孕周31周)采集阴道拭子,并接种于麦康凯琼脂平板上。使用VITEK-2自动紧凑型系统和纸片扩散法对菌落进行直接鉴定和药敏试验。通过表型方法确定ESBL的产生情况。在30%(918/3104)的阴道拭子中鉴定出 和 ,其中 最为常见(73%;667/918)。在47%(432/918)的肠杆菌科细菌中检测到ESBL产生,且多为多重耐药表型。碳青霉烯类耐药的总体患病率较低(8%)。超过20%的 菌株对碳青霉烯类耐药。孕妇定植率较高,可能在分娩时将ESBL-E传播给新生儿,这是一个需要考虑的重要危险因素。越南肠杆菌科细菌中ESBL产生菌和碳青霉烯类耐药的高发生率强调了后续监测和进行分子分型的必要性。

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